Venting anhedonia

[Donk]

i read that prolong use of antidepressant and benzo can cause anhedonia. by the same token, one of the symptoms of depression is anhedonia. if thats true then im totally fucked? i can't stop taking antidepressant because it will cause anhedonia however if i continue to take antidepressant i will continue to have anhedonia. am i thinking too much?

 

[flower]

in my experience anti depressants caused it for the first few weeks (along with worse suicidal tendencies) but it got better after adjusting to the meds. works differently for everyone though.

 

[TheGoodGuy]

I have had apathy and anhedonia for nearly six years that got worse by each passing year and that was without using drugs, I was actually hoping that if I get on SSRI´s in a few months it might give me a mood boost and maybe even get rid of the anhedonia my conclusion of this is because SSRI stands for selective serotonin reuptake inhibiter so I was hoping it would increase serotonin but I might be wrong.

 

[ohhgeeitsme]

My anhedonia became far worse after antidepressants. It comes in waves. Some days/weeks better than others. At least before when I was depressed, I could just watch TV. Now, I rarely have the strength to do that and when I try, I just can't get into and stop paying attention. Music does nothing, and I LOVE music. I can still knock about online, usually googling random thoughts, learning facts or on forums like these more than any other task I usually enjoy, but still will get bored easily with this and just give up and then spend hours simply lying in bed staring at the ceiling. Yes. That's my new thing now. I lie in bed and stare at nothing.. often times in complete darkness. Hallucinations are often. I went back to using phenibut after months off of antidepressants, about twice a week just to get a couple of days of relief. I'm on it now, so I don't feel so bad. So about one or two days a week, I can actually enjoy music again.

edit: the phenibut is actually for the akathisia, which it does help. but it also helps with the anhedonia, so bonus.

 

[TimeToBiteTheDust]

It sucks. I don't enjoy almost anything except music and some other things. I don't have energy even for washing dishes. And I sleep more than 9 hours!!!

 

[ExRN]

I've had complete physical anhedonia for at least 3 years and it's possible that antidepressants have caused it. I've tried over 30 different antidepressants (including SSRIs, SNRIs, a TCA, MAOIs and others like mirtazapine and bupropion that aren't as easily classified) over the past 25 years, and was pretty stable and functional on meds up until the past 4+ years. I could always enjoy music, or a cigarette even when I was very depressed, but now I can't even cry. The majority of different meds I've tried were prescribed to me over the past 5 years (about a year after losing my career) and I was diagnosed with "treatment refractory depression" (TRD) with anhedonia -- I was hospitalized for ECT on 2 occasions, then for a trial of i.v. ketamine, and again to start an antipsychotic (clozapine) off label for treatment resistant depression and suicidal behaviour. I even tried Transcranial Magnetic Stimulation (rTMS) for depression. I developed INTENSE akathisia as a withdrawal side effect of clozapine (a drug that can cause a lot of nasty side effects, but I found it helped with the insomnia). I had done my own research on buprenorphine for anhedonia. Some studies have shown efficacy of buprenorphine for anhedonia but I've been taking it (in the form of bupreorphine-naloxone or Suboxone) since the beginning of this year and I still can't experience pleasure of any kind, but it DID work for the akathisia.

As a last-ditch effort, I've decided to stop all antidepressants and valium (I was taking 40mg of valium daily -- I cut that down to 10mg over the past 2 months) because I think if the antidepressants aren't working for me (and there's the possibility they could be making things worse), it's worth eliminating them to see what I'm like drug free. To experience no pleasure and just emptiness or suffering all waking hours is no way to live.

 

[Mm80]

Just a slightly alternate view, ssris target serotonin.
My unqualified opinion is that anhedonia may also or be affected by the dopamine (pleasure, reward) system and possibly norepinephrine (concentration focus) system too.
I believe that psychiatry is too narrow and just sees an ssri as the answer.
Maybe look at dopamine and or norepinephrine reuptake inhibitors

 

[ExRN]

Just a slightly alternate view, ssris target serotonin.
My unqualified opinion is that anhedonia may also or be affected by the dopamine (pleasure, reward) system and possibly norepinephrine (concentration focus) system too.
I believe that psychiatry is too narrow and just sees an ssri as the answer.
Maybe look at dopamine and or norepinephrine reuptake inhibitors

SSRIs affect the firing of serotonergic neurons, and that does alter dopamine availability in certain brain regions. I agree that the old monoamine theory of depression is too narrow and other theories of depression exist. Some psychiatrists I've met with seem not to understand anhedonia. Reward and hedonic tone are areas of research that don't typically come up in a 5 - 10 min. visit to a psychiatrist. I think it's important to treat anhedonia as a separate entity from depression. My experience as a patient (who also took some grad-school courses in psychiatry and neurobiology) is that I have to do my own work and find out what works for my brain. I can't rely on a psychiatrist to know the answer (I wish I could).

 

[Mm80]

SSRIs affect the firing of serotonergic neurons, and that does alter dopamine availability in certain brain regions. I agree that the old monoamine theory of depression is too narrow and other theories of depression exist. Some psychiatrists I've met with seem not to understand anhedonia. Reward and hedonic tone are areas of research that don't typically come up in a 5 - 10 min. visit to a psychiatrist. I think it's important to treat anhedonia as a separate entity from depression. My experience as a patient (who also took some grad-school courses in psychiatry and neurobiology) is that I have to do my own work and find out what works for my brain. I can't rely on a psychiatrist to know the answer (I wish I could).

Thank you for adding the technical stuff, thats a good point imo about treating the two separately. Ive read a little bit about ssris affecting the dopamine system not sure how it happens though.
Any opinions on DRI s or NRIs or a combination?
Im currently taking stattera and i feel it helps. Ive took ssris and although i dont feel as deoressed, they make me very impulsive and a bit manic.
Thanks

 

[Sk1n1M1n]

My anhedonia became far worse after antidepressants. It comes in waves. Some days/weeks better than others. At least before when I was depressed, I could just watch TV. Now, I rarely have the strength to do that and when I try, I just can't get into and stop paying attention. Music does nothing, and I LOVE music. I can still knock about online, usually googling random thoughts, learning facts or on forums like these more than any other task I usually enjoy, but still will get bored easily with this and just give up and then spend hours simply lying in bed staring at the ceiling. Yes. That's my new thing now. I lie in bed and stare at nothing.. often times in complete darkness. Hallucinations are often. I went back to using phenibut after months off of antidepressants, about twice a week just to get a couple of days of relief. I'm on it now, so I don't feel so bad. So about one or two days a week, I can actually enjoy music again.

edit: the phenibut is actually for the akathisia, which it does help. but it also helps with the anhedonia, so bonus.

I use phenibut too, what a brilliant all round drug

 

[ExRN]

Thank you for adding the technical stuff, thats a good point imo about treating the two separately. Ive read a little bit about ssris affecting the dopamine system not sure how it happens though.
Any opinions on DRI s or NRIs or a combination?
Im currently taking stattera and i feel it helps. Ive took ssris and although i dont feel as deoressed, they make me very impulsive and a bit manic.
Thanks

Hi Mm80, my view is that psychiatrists prescribe drugs based on their interpretation of how they understand mood disorders. Explaining the mechanism of action of Strattera as an NRI may be simplistic, but in certain brain regions that have been studied, that's how it appears to act. Strattera also increases the number of glutamate receptors (glutamate is an excitatory neurotransmitter) in certain neurons in animal models. Strattera likely has an effect on brain regions important to mood that haven't been studied, but the best guess is that the drug would work as a treatment for ADHD in humans because glutamate receptor functioning is thought to be impaired in the disorder. I've tried Modafinil, Dexedrine and Adderall with different success as adjuncts to other antidepressants (to boost my mood). I chose to ask for Modafinil, in part because it's reported to act as a DRI but also because Adderall was making me feel anxious even though I'd taken it for a long time. Modafinil seemed to boost my mood without causing the anxiety. Drugs that affect the dopamine system (i.e. those that improve neurotransmission in pathways associated with reward) and have been studied in clinical trials to treat what they're designed to treat would probably have increased benefit to someone who suffers from anhedonia. It's sounds simplistic (that I would consider asking for a med. that acts as a DRI) since my aim is to combat anhedonia and facilitate reward, and it might be, but that's my take.

 

[Mm80]

Hi Mm80, my view is that psychiatrists prescribe drugs based on their interpretation of how they understand mood disorders. Explaining the mechanism of action of Strattera as an NRI may be simplistic, but in certain brain regions that have been studied, that's how it appears to act. Strattera also increases the number of glutamate receptors (glutamate is an excitatory neurotransmitter) in certain neurons in animal models. Strattera likely has an effect on brain regions important to mood that haven't been studied, but the best guess is that the drug would work as a treatment for ADHD in humans because glutamate receptor functioning is thought to be impaired in the disorder. I've tried Modafinil, Dexedrine and Adderall with different success as adjuncts to other antidepressants (to boost my mood). I chose to ask for Modafinil, in part because it's reported to act as a DRI but also because Adderall was making me feel anxious even though I'd taken it for a long time. Modafinil seemed to boost my mood without causing the anxiety. Drugs that affect the dopamine system (i.e. those that improve neurotransmission in pathways associated with reward) and have been studied in clinical trials to treat what they're designed to treat would probably have increased benefit to someone who suffers from anhedonia. It's sounds simplistic (that I would consider asking for a med. that acts as a DRI) since my aim is to combat anhedonia and facilitate reward, and it might be, but that's my take.

Thank you, appreciate the detailed insight and hope it helps others

 

[Sk1n1M1n]

So I can be a productive student and get coursework done, to increase the long nights on the mac